Running SHoes

In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser MD, Dr. Kate Mihevc Edwards PT, and sports dietitian Kelsey Pontius discuss a common running injury that is often misunderstood: metatarsal pain, or forefoot pain. Using the case of a recreational runner in her mid-20s who recently increased her mileage after joining a social running group, they discuss the many factors that can contribute to forefoot pain from rapid training increases and footwear choices to biomechanics, nutrition, and overall load management. The conversation highlights how lifestyle changes such as walking more in a new city, wearing heels for work, increasing weekly mileage, and under-fueling can all add up to overload the body. They discuss how clinicians evaluate metatarsalgia, when imaging may be necessary, and why assessing gait mechanics, strength, and movement patterns is essential for long-term recovery. The episode also explores the role of nutrition in injury prevention, including the importance of fueling appropriately when transitioning from casual exercise to training like an athlete. Listeners will also hear discussion around common contributors to forefoot pain such as calf tightness, forefoot loading, Morton’s neuroma, footwear transitions, and even referred pain coming from the lower back. Throughout the episode, the importance of treating the whole athlete not just the painful area is emphasized, along with understanding whether the body can truly tolerate the physical and mental load being placed upon it. Whether you’re a runner dealing with foot pain, a clinician treating runners, or someone trying to better understand training load and recovery, this episode provides practical insights into injury prevention, rehabilitation, and performance optimization. 00:00 – Welcome to Interdisciplinary Case Miles Introduction to the podcast and the interdisciplinary approach to runner health and performance. 01:20 – The Case: Recreational Runner with Forefoot Pain A runner in her mid-20s develops metatarsal pain after increasing mileage and joining a social run group. 03:00 – Understanding Metatarsalgia Dr. Sara Raiser MD explains why forefoot pain is often multifactorial and requires a broad differential diagnosis. 05:30 – Stress Fractures & Medical Red Flags Discussion around bone stress injuries, imaging, neurological screening, and determining when further investigation is needed. 09:15 – Biomechanics, Gait & Foot Loading Dr. Kate Mihevc Edwards PT reviews running mechanics, calf tightness, forefoot loading patterns, and mobility considerations. 14:00 – Morton’s Neuroma, Orthotics & Footwear Choices Discussion around nerve irritation, shoe structure, metatarsal pads, toe spreaders, and footwear transitions. 17:30 – Nutrition, Under-Fueling & the “Girl Dinner” Problem Kelsey Pontius explains how convenience eating, low carbohydrate intake, and under-fueling can contribute to injury risk. 24:00 – Shifting Into the Athlete Mindset Why recreational runners often underestimate their training demands and recovery needs. 28:00 – When Foot Pain Might Actually Be Coming From the Back The importance of screening for referred pain, neural tension, and lumbar spine involvement. 34:00 – Training Load Includes More Than Running How walking, commuting, standing at work, and social activity all contribute to overall load. 39:00 – Managing Recovery & Modifying Activity Strategies for reducing stress on the foot while maintaining activity and supporting healing. 43:00 – Key Takeaways for Runners & Providers Final thoughts on strength, biomechanics, fueling, and finding clinicians who understand runners. 46:00 – Closing Thoughts & Listener Questions How listeners can submit their own running cases and support the podcast. #RunningInjury #Metatarsalgia #Running #FootPain #SportsMedicine #PhysicalTherapy #SportsNutrition #LoadManagement #MarathonTraining #InjuryPrevention #RunningPodcast #SportsRehab #IDCMpodcast #InterdisciplinaryCaseMiles

A 41-year-old female runner and experienced half-marathoner develops mid-Achilles tendon pain, morning stiffness, and a noticeable bump along the tendon. Symptoms improve after warming up but return with longer runs, leaving her caught in the common cycle of pushing through pain, resting without progress, and uncertainty about what actually helps. In this episode of Interdisciplinary Case Miles, Dr. Sara Raiser (MD) , Kelsey Pontius, and Dr. Kate Mihevc Edwards (PT) discuss the clinical presentation of Achilles tendinopathy, why it often becomes chronic, and why complete rest is rarely the solution. Key topics include: Tendon loading principles and why tendons require progressive strength work Biomechanical contributors such as foot control, dorsiflexion limits, hip extension, and proximal weakness The role of perimenopause, estrogen changes, and life stress in tendon vulnerability Nutrition foundations for tendon healing, including energy availability, collagen synthesis, and carbohydrate support Practical considerations around footwear, heel-to-toe drop changes, and carbon-plated shoes If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives. This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes and stronger runners. 00:00 – Welcome to Interdisciplinary Case Miles Hosts introduce the evidence-informed case format. 02:05 – Case Presentation: Mid-Achilles Pain in a Half-Marathon Runner Morning stiffness, crepitus, tendon thickening, and pain that fluctuates during runs. 05:10 – Why These Cases Are Challenging The warm-up effect, post-run soreness, and training “push-through” patterns. 08:20 – Medical Evaluation Priorities Training changes, hormonal factors, surgery history, and load management. 12:30 – Tendons Require More Than Rest Why conservative care emphasizes strength, mechanics, and progressive loading. 16:10 – Foot Posture and the Kinetic Chain Rigid vs flexible feet, arches, glute engagement, and core contribution. 20:05 – Achilles Mechanics: The “Wringing Out” Effect How pronation and poor control increase tendon stress. 24:40 – Running With Tendinopathy: Pain Monitoring Guidelines When continued running can be appropriate and how to track symptom response. 28:10 – PT Interventions: Eccentrics, BFR, and Load Progression Strength-based tendon rehab and improving blood flow. 32:45 – Nutrition for Tendon Healing Energy availability, collagen synthesis decline with age, and micronutrient support. 37:20 – Collagen Supplement Timing and Practical Use Why collagen works best 30–60 minutes before tendon loading. 41:10 – During-Run Fueling and Injury Risk Carbohydrate needs, glycogen depletion, fatigue-related mechanics breakdown. 45:30 – Chronic Tendon Changes Take Time Why tendinopathy develops over years and requires patience in rehab. 48:10 – Proximal Drivers: Low Back, Hip Extension, and Glute Function How upstream issues overload the Achilles. 52:20 – Footwear Considerations and Heel-to-Toe Drop Shifts Carbon-plated shoes, shoe rotation, cushion effects, and transition errors. 57:30 – Final Takeaways Sara: Tendon recovery takes time but allows continued activity Kelsey: Fueling protects long-term tissue health Kate: Rest alone fails tendons need load and strength adaptation 1:01:30 – Closing and Case Submission Info #running #runninginjuries #runnerhealth #sportsmedicine #sportsnutrition #physicaltherapy #wellness #nutrition #enduranceathletes #tendinopathy #achillespain

Foot pain that lingers, comes and goes, or never fully heals can signal something more serious especially in runners. Episode 19 of Interdisciplinary Case Miles centers on a high school track athlete dealing with a navicular bone stress injury that persisted for nearly a year. This type of injury is one of the most challenging in running due to limited blood supply, high biomechanical demand, and the need for strict management early on. This case highlights how bone stress injuries develop from a combination of training load, biomechanics, and nutrition especially low energy availability in adolescent athletes. It also addresses why navicular injuries require careful progression, non-weight bearing phases, and long-term follow-up to avoid delayed healing or recurrence. You’ll hear how foot mechanics, posterior tibial function, and arch control influence stress at the navicular, along with how strength, mobility, and confidence all play a role in returning to sport. The conversation also emphasizes the importance of fueling, growth demands, and the unique challenges faced by youth and first-generation athletes navigating high training loads. Whether you’re a runner dealing with stubborn foot pain, a parent supporting a young athlete, or training in high-impact environments like track, trail, or jumping sports, this episode provides clear direction on preventing and managing navicular stress injuries. 00:00 – Intro to Interdisciplinary Case Miles Overview of the podcast and today’s complex case. 01:05 – Case Overview: High School Athlete with Persistent Foot Pain Track athlete with a year-long navicular bone stress injury. 03:10 – What Is the Navicular Bone & Why It Matters Location, function, and role as the “keystone” of the arch. 06:00 – Why Navicular Stress Injuries Are High Risk Limited blood supply and challenges with healing. 09:20 – The Perfect Storm: Load, Biomechanics & Nutrition How multiple factors combine to create bone stress injuries. 12:40 – Low Energy Availability in Young Athletes How underfueling impacts bone health and recovery. 16:30 – Growth, Development & High Calorie Needs Why adolescent runners require more fuel than expected. 20:10 – Practical Fueling Strategies for Busy Athletes Snacking, meal timing, and closing energy gaps. 24:00 – Posterior Tibial Function & Foot Mechanics How pronation control affects stress at the navicular. 27:45 – Physical Therapy Approach to Navicular Injuries Strength, mobility, stability, and load management. 31:20 – Confidence & Fear in Return to Sport Mental barriers after long-term injury. 35:00 – When to Repeat Imaging & Monitor Healing Using MRI and clinical signs to guide progression. 38:40 – Surgical vs Conservative Treatment Options When athletes consider early intervention. 42:10 – Athlete Stage Matters: Youth vs Elite Decisions How treatment varies by age and competition level. 45:30 – Key Takeaways from Each Expert Education, fueling, and whole-athlete care. #runninginjury #stressfracture #footpain #navicular #runnersofinstagram #trackandfield #highschoolathlete #youthathletes #runningtips #injuryprevention #sportsmedicine #physicaltherapy #sportsrehab #runhealthy #runstrong #ultrarunning #trailrunning #marathontraining #tracknation #runnerlife #sportsnutrition #fuelingforperformance #lowenergyavailability #REDs #bonehealth #enduranceathlete #runpainfree #mobilitytraining #strengthtrainingforrunners #biomechanics #returntosport #confidencebuilding #mississippirunners #southernrunners #denverrunners #trackathletes #distanceathlete #jumper #sprinter #evidencebased

Are you hobbling to the bathroom in the morning because of heel pain? Many runners with plantar fasciitis ignore that early symptom for months until it starts affecting every run. In episode 16 of the Interdisciplinary Case Miles Podcast, Dr. Sara Raiser, sports medicine physician and running specialist, Dr. Kate Mihevc Edwards, orthopedic physical therapist and running PT, and sports dietitian Kelsey Pontius break down a real runner case involving chronic plantar fasciitis that slowly worsened over time. The case involves a 42-year-old runner who runs 3–5 miles nearly every day to manage work stress. For over a year she ignored classic plantar fasciitis symptoms, morning heel pain and stiffness after sitting because the pain would improve once she started moving. Eventually, the pain began showing up during her runs and getting worse halfway through, forcing her to finally seek help. In this episode, the team explains why plantar fasciitis often becomes a chronic plantar fasciopathy, why morning heel pain happens, and why runners often wait far too long before addressing the root causes. You’ll learn: Why morning heel pain and hobbling after sitting are classic plantar fasciitis symptoms Why many runners develop plantar fasciitis after months or years of subtle warning signs Why foot strength and running mechanics matter more than stretching alone The role of calf mobility, great toe motion, and the kinetic chain in plantar fascia loading When treatments like shockwave therapy, PRP, or injections may be appropriate Why plantar fasciitis rehab can take 6–9 months for chronic cases How nutrition, protein intake, vitamin D, and micronutrients support connective tissue healing The mental side of injury when running is your primary stress relief How long rehab realistically takes If you're a runner struggling with heel pain, plantar fasciitis, or foot pain when you first step out of bed, this episode will help you understand what’s really happening and how to recover without giving up running. If you’re enjoying these conversations, please follow the podcast and take a moment to rate or review it. Sharing it with a runner, coach, or healthcare provider helps us reach the people who can make the biggest difference in athletes’ lives.This podcast is for runners at every level, the coaches guiding them, and the healthcare professionals who care for them. We believe interdisciplinary care leads to better outcomes and stronger runners. #InterdisciplinaryCaseMiles#IDCMpodcast#PlantarFasciitis#PlantarFasciopathy #HeelPain#RunningInjury#Runners#RunningRecovery#PhysicalTherapy#SportsMedicine#GaitAnalysis#FootStrength#CalfTightness#VegetarianRunner #SportsNutrition